Different
strategies may be used to differentiate live immotile
spermatozoa from dead ones, thus aiding in the selection of
viable gametes for ICSI; Including Hyposmotic Swelling (HOS)
test, Sperm tail flexibility test, Motility stimulant sperm
challenge using Pentoxifylline. More recently Theophylline has
been tested as a chemical tool for stimulating spermatozoa. This
study was designed to compare ICSI outcome in two groups of
azoospermic men subjected to testicular sperm extraction. Sperm
selection for ICSI by Sperm tail flexibility test is used for
the first group and chemical selection by Theophylline will be
used in the second group. The present case control study
included 22 obstructive azoospermic men. They were categorized
into two subgroups according to method of selecting immotile but
viable spermatozoa (Sperm tail flexibility test and Theophylline).
The median time needed for sperm selection in all patients in
the study group was highly significant less than that needed for
the control group, 15.5 versus 34.5 minutes (P<0.001). Median
time for single sperm isolation was highly significant less in
study group than in control group, 2.1 versus 5.21 minutes
(P<0.001).Additionally, clinical pregnancy outcome was highly
significantly higher in the study group than in the control
group, P<0.001. Theophylline reduced significantly the time
needed for sperm isolation from fresh testicular samples,
upgraded embryo quality, increased significantly implantation
rate in ICSI and increased significantly biochemical and
clinical pregnancy outcome in ICSI procedures as an assisted
reproductive technique carried out on azoospermic male patients.